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Home My WebLink About1625 CORMORANT DR; ; CB070815; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 03-26-2007 Plumbing Permit Permit No CB070815 Building Inspection Request Line (760) 602-2725 Job Address 1625 CORMORANT DR CBAD Permit Type PLUM Status ISSUED Parcel No 2156500404 Lot# 0 Applied 03/26/2007 Construction Type NEW Entered By KG Reference # Plan Approved Issued Project Title HERSHMAN RES REPLACE WTR HTR Inspect Area Applicant Owner AFFORDABLE WATER HEATER HERSHMAN 1997 TRUST 24707 SAN FRANANDO RD 1625 CORMORANT DR SANTA CLARITA, CA 91321 CARLSBAD CA 92011 661 259-7131 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees 0 0 0 0 1 0 0 $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $27 00 Total Fees $27 00 Total Payments To Date $27 00 Balance Due $0 00 Inspector —yj IN/v Date U HY—I Clearance NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions" You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a) and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 51.; ;rf;PROJECT;iNFORMATION run urrioe uoc PLAN CHECK EST VAL _ si Plan Ck Deposit //>/ Validated By /^ Date '/ Address (include Bldg/Suite »}Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total * of units Assessor & Parcel #Use ; . In fZbh Proposed Use Description of Work SQ FT #of Stones # of Bedrooms tt of Bathrooms (if different from applicant) Address it for.Contractor -d Owner Q Agent" ' " -r/cftti City State/Zip Telephone » Fax » - •-...*, r\\]£&4frte(f\'L\ :"\tt\fJk?£*h'{3( Name ]*•( -liPROPERTY,'owNER ? .£ «!,•- •-. *~ City State/Zip Telephone tt - "'* ' v"' "*>' Name City State/Zip Telephone # (Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exa/nptitfn Any Violatipn 9f Sectipn 703,1 f by any. applip4nt !°r ? Permit subjects the applicant to a^civil^nalty of qpunore than five hun/lred doljafj [^500]) Namet * , State License tt *-£ . Designer Name State License tt 2-736^Address License Class Address r %(*City ' City City State/Zip Business License tt j State/Zip Telephone tt /~iA--£/j I'2 s~t \ —-7 *\ — j i C^/'* I \. ^2J 72/71 Telephone Ul 111! /Sue v6'!;,.j.WORKER.5!'LCQMFJN3ATIpN-i' ....U'..:..; .., . , '• .• , „ : ;...'• ';;.. • •' ..;.„-. i..' , Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~l I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ued My worker's compensation insurance carAer and policy number are Insurance Company \V\JL /J^LhH^ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) D CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California WARNING Failure to secure^workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($TOO,OOOl/tna<ldi[ioq'fo~ihe cost of compensation, damages as provided for in Section 3706 of the-^abo/ cpcja, irperest-afid attorney's fees SIGNATURE \-^l \ A DATE Policy No (_JjJ) / Q ^ Q I Q| Expiration Date \ /~~ \ O ft f'j.^i' »'-:. ':•• •"'•'• <•• "•' '» -* •"• '<*•'< •• •> * :"£t !;"i " ••"'•> -.f- "• '-><",/'•»(•-,•" v°<" •• : -•/•<•",«,.,« '.""yTrifi i I hereby affirm that I am exempt from the Contractor's License Law for the following reason I"] I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec 7044, Business and Professions Code The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale) Q I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business and Professions Code The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law) C] I am exempt under Section Business and Professions Code for this reason 1 I personally plan to provide the major labor and materials for construction of the proposed property improvement Q YES QNO 2 I (have / have not) signed an application for a building permit for the proposed work 3 I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number) 4 I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number) 5 I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work) ^ PROPERTY OWNER SIGNATURE DATE iCOMRLETE THIS SECTION FOR/vdW-flfS/O£«77/U BUILDING PERMITS ONLY: , "* , r , -, , r ;, ". ", ..,,;,, ;f . , ,, ,&«;„; , .,, •.., Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? C3 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO Is the facility to be"c^nstructed within 1,000 feet of the outer boundary of a school site? O YES Q NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT :8. i CONSTRUCTION LENDING AGENCY / ' ":^. , ., .'.,:< ," , •'• I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER S NAME LENDER'S ADDRESS 19. V,; i,APPt)CANT CERTIFICATION, fi.~-. .,-,•.-' -t .. r, ,, , . • ; :. ., ;.,,.„ ,, .. ,,;.„*, '^L,<ii*l.~.;..r.f'>_.,, ,,-. V:;, I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate I agree to comply with all City ordinances and State laws relating to building construction I hereby authorize representatives of the CitV of Carlsbad to enter upon the above mentioned property for inspection purposes I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height EXPIRATION Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced vvipnin 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned ' ./-.-- |ayS (Sect|0n Toe 4 4 Uniform Building Code)at any time after the work is commenced fi APPLICANT S SIGNATURE DATE VHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 04/10/2007 Permit* CB070815 Title HERSHMAN RES REPLACE WTR HTR Description Sub Type 1625 CORMORANT DR Lot 0 Type PLUM Job Address Suite Location OWNER HERSHMAN 1997 TRUST Owner HERSHMAN 1997 TRUST Remarks Inspector Assignment Phone 7604380918 Inspector Total Time CD Description 25 Water Heater/Vents Act Comments Requested By MS HERSHMAN Entered By CHRISTINE Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments LETTER OF AUTHORIZATION "I, undersigned, give permission to accept any of the signatures that appear below, on a permit being issued, in lieu of my signature at the counter. I hereby certify under penalty of perjury, that I will comply with all declarations and agreements on the permit, which bears my signature or my representative signature, and as required by this city." The following authorized representatives have my permission to sign and take receipt of construction permits in thejiangptff my company. Leonce Roux Contractor Name Katie LaKamp Authorized Representative :ot Signature iresentative Signature Undersigned Contractor Information: Leonce Roux /s^sZT < V^'/^^o Contractor's Name Affordable Water Heaters and Plumbing, IncX Company Name x 24707 San Fernando Road, Santa Clarita, CA 91321 Company Address TTie Zenith Worker's Compensation Insurance Carrier 627368 C36 Contractor's State License Number and Class Signature 661-259-7131 Phone Number 661-259-9556 Pax. Number #2067898701 Policy Number 09-30-2006 Expiration Date Date ' 01/01/2007 Expiration Date ACTIVE LICENSE Afian 627368 «-, CORP AFFORDABLE WATER HEATERS AND PLUMBING INC —w C36 09/30/2008 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE TheZenith ZENITH INSURANCE COMPANY Company No 13145 21255 CALIFA ST WOODLAND HILLS, CA 91367 ITEM1 INSURED NAME AND MAILING ADDRESS PHYSICAL LOCATION PRODUCER 091177A 100 Renewal of Z067898701 AFFORDABLE WATER HEATERS AND PLUMBING INC 24707 SAN FERNANDO RD SANTA CLARITA, CA 91321 Policy Number Z067898702 DIRECT BILL 24707 SAN FERNANDO RD SANTA CLARITA, CA 91321 Policy Type: WN Line NON-PARTICIPATING Entity. CORPORATION Billing Type: PAYROLL Frequeacy: MONTHLY OTHER WORKPLACES NOT SHOWN ABOVE FEIN. 95^660066 See WC-00-99-05 - ADDITIONAL LOCATION ENDORSEMENT HOGAN INSURANCE SERVICES, INC PO BOX 7419 THOUSAND OAKS, CA 91359-7419 ITEM 2 The Policy Period is from: 01/01/07 to: 01/01/08 12:01 A.M. standard time at the insured's mailing address ITEM3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here CALIFORNIA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3 A The limits of our liability under Part Two are- Bodily Injury By Accident $ 1,000,000 Each Accident Bodily Injury By Disease $ 1,000,000 Each Employee Bodily Injury By Disease $ 1,000,000 Policy Limit C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here All states except states listed in item 3.A and NORTH DAKOTA, OHIO, WASHINGTON, WEST VIRGINIA, WYOMING D. See attached list for endorsements and schedules. ITEM 4 The premium for this policy will be determined by our manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. See endorsement WC-99-00-01- RATING SCHEDULE Total Estimated Annual Premium $ 141,977 Minimum Premium $ 500 Deposit Premium $ 24,470 Countersigned At. Woodland Hills, CA On- 12/29/06 By WC-00-00-01A INSURFO